肥胖儿童阻塞性睡眠呼吸暂停的临床特征

目的 研究肥胖儿童合并阻塞性睡眠呼吸暂停（obstructive sleep apnea，OSA）的临床特征。 方法 对在深圳市儿童医院呼吸科行多导睡眠监测的肥胖并诊断为OSA的33例7~15岁儿童的临床资料进行回顾性分析，并选取50例体重正常的、性别及年龄相匹配的OSA患儿作为对照组。 结果 33例合并肥胖的OSA儿童中，常见的日间症状前3位为：注意力不集中30例（91%），嗜睡22例（67%），晨起疲劳21例（64%）；夜间症状前3位为：打鼾27例（82%），张口呼吸20例（61%），出汗16例（48%）。与正常儿童参考值相比，肥胖OSA组和对照组两组患儿浅睡眠延长，深睡眠缩短，快速动眼期明显缩短，但两组之间这些指标的比较差异无统计学意义（P>0.05）。与对照组比较，肥胖OSA组呼吸暂停低通气指数和阻塞性呼吸暂停低通气指数均显著增加（P<0.05）；快速动眼期及非快速动眼期氧减指数均显著增加（P<0.05）；肥胖OSA组睡眠期间最低血氧饱和度显著低于对照组（P<0.05）。 结论 肥胖合并OSA儿童临床日间症状以注意力不集中、嗜睡、晨起疲劳为主，夜间症状以打鼾、张口呼吸、出汗为主。与体重正常OSA患儿相比，肥胖合并OSA儿童的睡眠结构无明显差别，但呼吸事件及血氧饱和度下降更严重。 引用格式:

Clinical features of obstructive sleep apnea in children with obesity

Objective To study the clinical features of obstructive sleep apnea (OSA) in children with obesity. Methods A retrospective analysis was performed on the medical data of 33 obese children aged 7-15 years, who were diagnosed with OSA and received polysomnography (PSG) in the Department of Respiratory Medicine in Shenzhen Children's Hospital. Fifty OSA children with normal body weight, matched for sex and age, were enrolled as the control group. Results Among the 33 obese children with OSA, the three most common daytime symptoms were inattention in 30 children (91%), somnolence in 22 children (67%), and morning fatigue in 21 children (64%), and the three most common nocturnal symptoms were snoring in 27 children (82%), mouth breathing in 20 children (61%), and sweating in 16 children (49%). Compared with the reference values of normal children, both the OSA + obesity group and the control group had prolonged light sleep, shortened deep sleep, and a significantly shortened rapid eye movement (REM) period, while there was no significant difference in these indices between the two groups (P>0.05). The apnea-hypopnea index, obstructive apnea/hypopnea index, and oxygen desaturation index in both REM and non-REM periods in the OSA +obesity group were significantly higher than those in the control group (P<0.05), while the lowest blood oxygen saturation during sleep was significantly lower in the OSA + obesity group (P<0.05). Conclusions The children with obesity and OSA have the main daytime symptoms of inattention, somnolence, and morning fatigue and the main nocturnal symptoms of snoring, mouth breathing, and sweating. There is no significant difference in sleep structure between OSA children with obesity and those with normal body weight; however, respiratory events and blood oxygen saturation decline are more severe in OSA children with obesity. Citation: